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- Title
- FACTORS ASSOCIATED WITH COGNITIVE IMPAIRMENT IN WELLMOTIVATED CHRONIC NON-MALIGNANT PAIN PATIENTS EVALUATED FOR SPINAL CORD STIMULATION
- Creator
- Zalizniak, Kevin C.
- Date
- 2016, 2016-12
- Description
-
Cognitive impairment in individuals with chronic pain is frequently observed and clinically significant (McCracken, & Iverson, 2001). It has...
Show moreCognitive impairment in individuals with chronic pain is frequently observed and clinically significant (McCracken, & Iverson, 2001). It has long been recognized that emotional factors contribute to both patient perception of impaired cognition and verifiable cognitive impairment on testing (Burt, Zembar, & Niederehe, 1995). However, scientific consensus is lacking regarding how specific emotions, such as depression, anxiety, and pain catastrophizing impact cognition in chronic pain patients. Research seeking to clarify such relationships has been hampered by methodological shortcomings, which include limited sample sizes, non-objective measures, and failure to examine multiple emotional dimensions in unique samples (McCracken and Vowels, 2014; Moriarty, McGuire, & Finn, 2011). The present study examined factors that might contribute to cognitive impairment in this population using a sample of 78 chronic pain patients evaluated for surgical candidacy for spinal cord stimulator (SCS) implantation at the University of Illinois at Chicago. Use of such a sample ensured patients were wellmotivated to perform to the best of their ability, so as to increase their chance of being cleared for such a highly desirable procedure. Additionally, the vast majority of participants passed well-validated objective measures of effort. Hypothesized associations between attentional function as measured objectively by the RBANS attention index and a number of predictor variables: depression and anxiety, subjective pain experience, pain catastrophizing, somatization, and engagement in pain behaviors were not found, and subsequent analyses of proposed mediating relationships could not be performed. However, fully a third (35.9 percent) of our well-motivated sample did not show clinically significant impairment (below 85, or 1 SD below the mean), as was expected. Thus, it is possible that a well-motivated sample may have been less likely than samples used in previous investigations to show cognitive impairment overall. Strengths and limitations of the study are discussed, as well as clinical and research implications.
Ph.D. in Psychology, December 2016
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- Title
- FACTORS ASSOCIATED WITH EMOTION REGULATION FLEXIBILITY
- Creator
- Murphy, Jonathan W.
- Date
- 2015, 2015-07
- Description
-
Flexibly switching among emotion regulation strategies has been associated with healthy functioning. In studies with non-clinical samples,...
Show moreFlexibly switching among emotion regulation strategies has been associated with healthy functioning. In studies with non-clinical samples, people have been shown to flexibly choose between regulatory strategies when presented with negative stimuli of varying intensity levels. The present study used the emotion regulation choice task to investigate whether participant characteristics (depressive symptoms and difficulties in emotion regulation) were associated with differences in choice patterns and flexibility between two emotion regulation strategies. In order to compare groups, this study measured participants' sensitivity to negative stimuli by adding an image rating task before the choice procedure. Additionally, given the hierarchical structure of the data, this study utilized multi-level modeling analyses, which were more appropriate than analyses used in previous emotion regulation choice studies. The results show that participants with low and high levels of depressive symptoms have similar emotion regulation choice patterns and showed similar flexibility between strategies. On the other hand, particular difficulties in emotion regulation were associated with blunted emotion regulation flexibility. These findings suggest that particular difficulties in emotion regulation might better predict blunted emotion regulation flexibility between strategies than depressive symptoms. Finally, suggestions for future research in emotion regulation flexibility are provided.
M.S. in Psychology, July 2015
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